HITAC recommends leveraging demographic data to help patient matching

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Dive Brief:

A key advisory committee to the Office of the National Coordinator for Health IT voted unanimously Monday to recommend adding a slew of demographic data to the U.S. Core Data for Interoperability (USCDI) dataset, a standardized set of health data that would be interoperable nationwide under the proposed HHS interoperability rules.

The Health IT Advisory Committee wants ONC to add current and previous addresses, mobile and landline phone numbers, email addresses and the last four digits of a patient's Social Security number to the dataset, a move that should help match patients to their healthcare records, a key problem area highlighted by interoperability experts when the rules were announced in February.

HITAC also voted in its May meeting to approve several recommendations to improve the rollout of the interoperability rules, including clarifying that organizations must comply with all federal, state and local laws, should not adopt restrictive security practices in most cases and don't need to provide interoperable systems during an unforeseeable event, like a natural disaster.

Dive Insight:

Industry's recent push for free and unfettered data sharing across disparate healthcare systems won't go far unless it's clear what data belongs to whom, according to experts. Health IT executive association CHIME estimates roughly 20% of patients may not be matched to their records when seeking care at a location where they've already been seen.

Patient matching company Verato recently partnered with health IT security company Imprivata to try and improve patient identification using a combination of referential matching, which compares an outside record to a comprehensive reference database, and biometrics.

The Pew Charitable Trusts highlighted both strategies as two of four promising approaches in record-matching along with patients identifying their own records through online or smartphone portals and standardizing demographic indicators across systems.

HITAC's vote to encourage ONC to add demographic data to the USCDI is a major step in addressing the issue, although its decision to encourage but not recommend a specific unifying system like USPS addresses could inject confusion into a system that relies on standardization.

Stakeholders in a January Government Accountability Office report pointed to incorrect or inconsistently formatted demographic information in patient records as rthe source for many of the problems they encountered when trying to reconcile similar records.

"Using the U.S. Postal Service standard for address can meaningfully improve match rates, while previous research has shown that email addresses are already in half of patients' records and should also be used to improve matching," Ben Moscovitch, health IT project director at Pew, told Healthcare Dive.

"ONC should follow these two commonsense approaches that could help link an additional tens of thousands of records — or more — per day," Moscovitch said.

HITAC also voted to recommend ONC include provenance data, including author name, organization and time stamp; clinical notes, including consultation notes, discharge notes, history and physical notes and others; pediatric vital signs, provider demographic data and an address entry standard for homeless and displaced persons in the USCDI.

HITAC voted to recommend extension of the implementation timeline of the rules in response to industry concerns. It extended the time vendors and providers have to update their contracts after the rule takes effect to five years, with vendors proposing their plan for the contracts after two years.

Recommendations meant to clarify and refine the rules around "reasonably incurred" recovery costs, or fees levied by health IT providers for access to certain data, were deferred until HITAC's next meeting, May 22, following a nearly hour-long discussion.